Thursday, December 17, 2009

The difference between a mental illness sufferer and a jackass

When I get into online conversations, something happens about once a month. Either in an attempt to be compassionate or to condemn, somebody will declare that this corrupt politician, that creep, this annoying person or that wrong-headed one, is probably suffering from a mental illness. Inevitably the person making the comparison doesn't actually have much experience of mental illness, and consequently knows as much about it as anyone who hasn't studied it as a professional or encountered it in their personal lives does - which, in this society so appallingly under-educated when it comes to mental illnesses, is to say: very little.

Their understanding of terms like 'psychotic', 'paranoid', 'schizophrenic' or 'mentally ill', therefore, tends to be colloquial, and they're usually doing what everyone does, which is assume a word means pretty much what you were told it means. In cases where a word has two meanings, though, a colloquial and a clinical one, there are two distinct meanings, and it's not uncommon for someone to conflate the two.

I always end up saying the same thing, so I think I'll write a blog post explaining why you shouldn't do this. It's important.

Mental illness is not a behaviour or a character trait. It's an illness. People who suffer from a mental illness are physically ill. Depression involves damage to the hippocampus, for example, which is to say organic brain damage not unlike with Alzheimer's. Many mental illnesses involve some kind of chemical imbalance. Much treatment is currently what a doctor friend of mine refers to as a 'black box': you go in the black box, something happens, you come out the other side feeling better and no one's sure exactly what went on in the box. Which is to say that even doctors are still just chipping away at the edges of mental illness: while great strides are being made, it's still poorly understood. What's not in dispute is that mental illness is like diabetes or AIDS, an actual illness that the sufferer is not undergoing voluntarily. In many cases they're in agony and seriously considering killing themselves to get away from it.

One of the worst things about mental illness in this society is that it's deeply stigmatised. People sneer at the 'happy pills' that help people in anguish struggle back to health. No one wants to hire the schizophrenia sufferer. Admit you have a mental illness and you run the serious risk that the person you tell may decide you're weird and creepy or weak and self-indulgent and they want nothing more to do with you, even if you're bravely fighting every day and successfully beating it back and holding down a job, a family and a social life just like everyone else.

The stigma comes from the fact that we're ignorant. And I want to stress this: saying that someone's ignorant about mental illness isn't insulting them. Everybody's ignorant about it until their son or their best friend or they themselves go under. Personally I believe schools ought to put classes on mental illness at the same high priority that they should put sex education, because your chances of encountering mental illness are roughly equal to your chances of having sex, and both can be killers if you don't know what's what. But till that day, we none of us necessarily know very much about it.

But these are our brothers and sisters suffering from it, this is us. I've heard it estimated that three out of four people will get a mental illness at some point. We may start out not knowing enough about it, but we need to inform ourselves. People are dying, people are weeping in pain, people are losing their homes and their families and their friends. And they're good, normal, decent, ordinary people, no different from anyone else. They just got sick. It can happen to the best of us.

The problem with calling someone mentally ill because they're acting unreasonably is that it perpetuates false ideas about mental illness, and false ideas are what keeps the stigma going.

Often when I see someone call this person or that mentally ill, they're trying to be charitable. Saying that maybe this or that hateful demagogue is suffering from paranoid schizophrenia, for instance, sounds kinder than saying that they're either a liar or a fantasist. But it isn't, not when you remember that we're all connected. Calling someone clinically paranoid because they're hateful is conflating hatefulness with clinical paranoia. Calling a fantasist clinically paranoid is trivialising genuine involuntary delusions by implying they're mere daydreams. Calling someone wilfully ignorant clinically paranoid increases the stigma against sufferers by suggesting it's mere laziness or self-indulgence rather than real sickness that's troubling them - and the world is plenty full of people who are already saying that. It's a tremendous implied insult to the people struggling to keep paranoid schizophrenia from ruining their lives and the lives of everyone they love, and the people too sick to know how sick they are who are sleeping rough for fear their neighbours will kill them in the night, and the people who've been through that hell and fought their way out.

And that's just an example, but it holds true in other cases. There is a difference between a stupid belief and a clinical delusion, an unreasonable attitude or a nasty personality or a wilful disregard for the truth and a mental illness. People are prone to imply someone's mentally ill (however they vaguely understand the term) when that someone is actually just being a jackass. And if you conflate 'jackass' with 'mentally ill', you're insulting millions of people in pain. You are also factually incorrect.

Yes, a lot of us don't actually know what the words precisely mean. So if you want to use the word, go away and look it up. There is plenty of information out there. If you don't know what a word means you have no business using it, especially when it refers to a real medical problem. Mental illness is often depicted in fiction, often inaccurately, but it's not a fictional condition. It's a common, ordinary kind of disease that destroys people every year, every month, every day.

Saying that someone's mentally ill because they're being stupid or weird perpetuates the stereotypes that ostracise and isolate and hurt all the good people who happened to be unlucky enough to have a disease. It isn't charitable, it isn't funny, it isn't accurate. It kicks people who are down.

We all of us need to be better informed about mental illness, because one way or another it's going to affect all of us. Using such words casually and ignorantly spreads misinformation and makes things worse. Please don't do it.

Wednesday, December 16, 2009

Private Christmas traditions

Most families have Christmas traditions of some sort, but what about personal ones? Do you have those?

I tend to set aside a few hours to wrap the gifts I'm giving - I actually love wrapping - while watching Little Women with candles and a lit Christmas tree. It's very cosy and I always look forward to it.

Wednesday, December 09, 2009

Mikalogues In Session

Okay, I admit it: I have been remiss in keeping the blog up to date recently and my last post was about cookies. I'm sorry; I've been going through an intellectual dry spell with nothing particularly fascinating to say.

Mika: Never has fascinating things to say unless about kibble anyway.Kit: Mika, hush. I'm trying to write a blog post.

Anyway, it's now the season of good cheer and I was...

Mika: Is Mika the fascinating. Mika has blog fans. You just filler between episodes.Kit: Mika, that hurts my feelings. I'm a professional novelist. I write good blog posts.Mika: Are they about kibble?Kit: Not usually, but...Mika: Mika rests case.

... excuse me. I was thinking that it might be a festive thing to try and ...

Mika: But Mika is festive. Is attractively patterned gold and white and brings cheer whereever goes!Kit: Yes, darling, that is true, you are a lovely puss.Mika: So why ignoring?Kit: Do cats celebrate Christmas?Mika: Cats celebrate anything that has fish treats in it. Kit: That's very ecumenical of you, honey.Mika: Will there be fish treats?Kit: If you like, pet. Now will you excuse me?